Background: Few medical education programs provide hands-on classes using electronic medical charts for a large number of students.
Methods: To simulate a medical interview, third- and sixth-year medical students viewed electronic medical chart samples on a screen, created by FileMaker, and discussed patient management. Following this, they underwent a questionnaire survey.
Results: A total of 63.1 and 76.3% of the third- and sixth-year students responded to the questionnaire, and 87.1 and 78.9% of the responders became interested in the class, respectively, because it focused on hands-on, practical training. A total of 5.6% of third-year students stated that the class was difficult to master but they hoped to continue learning.
Discussion: The adoption of a hands-on class using electronic medical charts interested even junior medical students.

The aim of this study was to investigate the relationship between heart rate variability (HRV) during exercise and ventilatory threshold (VT), using the MemCalc system which is superior in spectral analysis. Nine healthy male subjects with no cardiopulmonary disease performed an exercise test to exhaustion to determine VT on a bicycle ergometer. Low frequency (LF : 0.04-0.15 Hz), high frequency (HF : 0.15-0.40Hz) and LF/HF ratio power spectra were calculated by maximum entropy method (MEM) spectral analysis, using the MemCalc system. In each case, when the subject started exercise, the HF component declined rapidly during the first 30 seconds ; and compared to the resting value, it declined to approximately 5 % at VT. The possibility of using this phenomenon as a criterion for setting intensity of exercise is tinder consideration. The LF/HF ratio showed different patterns of variation among the subjects. A significant linear relationship was seen between the declining rate of the HF component and VT (r=0.93, p<0.001), suggesting a corres pondence between the heart's capability of adjusting to maintained exercise and high endurance capacity.

PREAVOID is pharmaceutical intervention that is utilized to illustrate pharmacists’ contributions to medical care.  Currently, there is a great need for pharmacists to provide good medical services to inpatients; as a result, many pharmacists conduct pharmaceutical management in hospital wards.  However, pharmacists who have limited experience in working in the ward do not know exactly what they should check with respect to pharmaceutical management.  To resolve this problem, we determined 16 pharmaceutical-management items based on PREAVOID that was conducted at Nagara Medical Center.  Moreover, we conducted a pre-questionnaire survey assessing whether pharmacists who had worked in the ward for fewer than 4 years attended to these 16 check items in their daily work prior to our introducing the list to them.  The results indicated that pharmacists who had fewer than 2 years of experience working in wards attended to the 16 check items less than those who had more than 2 years of experience, and approximately half of the pharmacists had not received adequate guidance before beginning work at the ward.  In addition, most pharmacists indicated that clear check points were useful for conducting pharmaceutical management and the 16 check items were useful for their daily work.  These results indicate that the 16 check items are a useful educational tool for enabling pharmacists to conduct high quality pharmaceutical management from the initial stage and that using the 16 check items is superior to pharmacists only gaining this ability via prolonged experience working in the ward.

Introduction: We perform our trials in Tsurumi ward, Yokohama city aiming at reducing the number of “cancer refugees” to zero. State: There are many patients who receive cancer therapy outside their hometown. Once their treatment is finished due to progressive disease or deteriorating condition, they are told to leave the hospital and to get palliative care in their district. And they become so-called “cancer refugees”. The beds of palliative care units are limited so the ability to accept patients in case of emergencies is poor. In Tsurumi ward, here are a lot of home care clinics providing palliative care but the place patients want to be or receive palliative care when their condition deteriorates isn't fixed. We organized the “Tsurumi Homecare Network” as the core of medical cooperation, and have worked on improving palliative care and increasing patients who die at home. Specifically, our hospital has played a central role as a special place for palliative care, we send out our original questionnaire to home care clinics to find out how they perform palliative care and introduce patients to the appropriate clinic. Patients who are in need of hospitalization are assured acceptance. On the other hand, we propose the cancer treatment hospitals to follow their patients together with us from their early stage of cancer treatment. Problem: To maintain a good relationship for regional palliative care, improving the management for outpatients, strict and timely backup system, advanced quality of homecare-supporting staff for palliative care and cooperation between home care clinic doctors are necessary.